Bulletin of Rehabilitation Medicine

INTRODUCTION. Post-COVID is a common complication of COVID-19, occurring in more than a third of patients, and condition will persist for more than 3 months after infection with the SARS-CoV-2.

AIM. To evaluate impact and potential effectiveness of a comprehensive physical rehabilitation program on health of cardiac patients with complications of a previously suffered new coronavirus infection SARS-CoV-2 COVID-19.

MATERIALS AND METHODS. The study involved 128 cardiology patients with post-COVID syndrome. The study participants comprised three groups depending on the 12-week physical rehabilitation program. The effectiveness of rehabilitation was assessed through parameters of cardiopulmonary testing, as well as the 6-minute walk exercise test and the degree of dyspnea according to modified mMRC dyspnea questionnaire.

RESULTS. The mMCR index in CPR group was 1.0 [0.0–1.0] point, compared with 2.0 [1.0–2.0] in control and comparative groups (p < 0.05); exercise tolerance VO_2max increased by 8.3 ± 3.8 % (p < 0.05); normalization of heart rate and blood pressure in response to physical activity after 12 weeks in intervention group was 5.0 ± 2.1 % compared to comparative and control groups; 6MWT test results 688 m, in the intervention group, versus 490 m, for participants in control group (p < 0.05).

DISCUSSION. A comparative analysis of previously conducted studies confirmed pattern between the inclusion of combined cardiorespiratory training in the protocol for 12-week rehabilitation of post-COVID complications among cardiac patients, and a decrease in the degree of shortness of breath, as well as an increase in exercise tolerance.

CONCLUSIONS. Based on experimental data obtained, it is advisable to analyze the effects of Cardiopulmonary Physical Rehabilitation program in the framework of larger randomized clinical trials. This will allow a more detailed assessment of the clinical consequences, as well as the ability to adjust mode and dose of physical activity of proposed rehabilitation program.

INTRODUCTION. Indomethacin is a derivative of indoleacetic acid and has anti-inflammatory, analgesic and antipyretic effects. However, the results of numerous studies show that indomethacin, like many other nonsteroidal anti-inflammatory drugs (NSAIDs), have an inhibitory effect on the viability and functional activity of enterocytes. In this regard, the search for new ways to reduce the severity of side effects from the use of NSAIDs remains relevant. One of these approaches may be to enrich patients’ diets with non-drug biologically active compounds, including proteins. However, the effect of dietary proteins and biologically active peptides on NSAID-induced damage to the wall of the small intestine and stomach has not been sufficiently studied.

AIM. To evaluate the ability of a collagen-containing dietary supplement to protect human duodenal epithelial cells (HuTu-80 line) from indomethacin-induced damage.

MATERIALS AND METHODS. The composite collagen-containing hydrogel was provided by «FIRST ALIVE COLLAGEN» LLC (Russia) and is a registered dietary supplement. The work used a commercial culture of human skin fibroblast cells and human duodenal epithelial cells (line HuTu-80). The viability of intestinal cells and fibroblasts was assessed using light and fluorescence microscopy and flow cytometry methods.

RESULTS AND DISCUSSION. It has been established that indomethacin inhibits cell growth, causes apoptosis and death of enterocytes, and also leads to the accumulation of cells in the S-phase, which indicates a disruption in the regulation of the cell cycle. It was revealed that collagen hydrogel prevents cell death caused by indomethacin and reduces the number of apoptotic cells in the population. The protective effect of collagen hydrogel is characterized by normalization of the cell cycle of enterocytes and restoration of their growth and proliferative activity.

CONCLUSION. Thus, collagen hydrogel, in vitro, is able to reduce the pathogenic effect of indomethacin on human intestinal epithelial cells. The protective effect of collagen hydrogel is characterized by maintaining viability, inhibiting apoptotic processes, and maintaining cell cycle stability. The results obtained indicate the prospects of using a dietary supplement based on a composite collagen hydrogel as a prophylactic agent to reduce the risk of NSAID-associated gastrointestinal diseases. However, to confirm the therapeutic effectiveness of the dietary supplement, further research is necessary, both using experimental animal modeling of NSAID-associated diseases of the human gastrointestinal tract, and clinical studies.

INTRODUCTION. Osteoarthritis of the knee joint or gonarthrosis (GA) is one of the most common joint pathologies. The medical and social significance of GA is associated with its high prevalence and a significant percentage of premature disability and a significant deterioration in the quality of life due to persistent pain syndrome. Modern treatment of patients with GA includes a combination of pharmacological and non-pharmacological methods; physical therapy is the leading method of non-drug therapy. By now, a number of studies have been conducted to research the effectiveness of backward walking (BW) in people with GA.

AIM. Analysis of scientific data on the possibilities of using BW in the rehabilitation of patients with GA.

MATERIALS AND METHODS. A systematic search of literary sources by keywords was carried out: “backward walking”, “gonarthrosis”, “knee osteoarthritis”, “knee joint”, “rehabilitation”, “physical therapy”.

DISCUSSION. Recently, backward locomotion is increasingly used in medicine. Kinetic and kinematic analysis during BW showed a number of advantages over the usual method of movement, which can be successfully used for rehabilitation of patients with GA. BW is associated with less overload on knee joints. It is also one of the few natural ways of strengthening the quadriceps. It prevents excessive stretching of the anterior cruciate ligament and improves the stability of the knee joint. BW leads to a more cardiovascular and respiratory load and a more significant aerobic and anaerobic capacity of the organism compared with forward walking at similar parameters of physical activity.

CONCLUSION. There is evidence that adding BW to conventional physiotherapy treatment may further reduce pain, functional disability and improve the strength of the quadriceps muscles.

BACKGROUND. Post-traumatic myelopathy (combat injury) is a serious condition that leads to severe functional impairment requiring complex rehabilitation based on assessment of functional impairment. The use of sulfide-silt mud is used in sanatoriums of the eastern military district for the rehabilitation of patients with pathology of the musculoskeletal system according to generally accepted methods. Lake Bolshoi Taraskul in the Tyumen region is a natural reservoir of sapropels with unique biological properties.

AIM. Show on the example of a clinical case the results of an integrated approach in the rehabilitation of a patient with post-traumatic myelopathy as a result of combat trauma, implemented on the basis of an individual.

CASE DESCRIPTION. Patient, 32 years old, with post-traumatic myelopathy due to spinal injury. Upon admission, the indicators: rehabilitation routing scale — 5 points, Revermid mobility index — 4 points, Ashforth spasticity scale — 3 points, ASIA scale — B, FIM functional independence scale 99 points. Initially, the patient is transferred from the chair to the couch with minimal support, sits without additional support for more than 5 minutes, verticalization of the patient only using high support (high walkers). The comprehensive rehabilitation program included physiotherapy, hydrokinesotherapy and peloidotherapy with Lake Taraskul sapropels. As a result of treatment, the patient walks with a support on a walker on a flat surface with rest, walks along the wall with a support on handrails. A patient supported by canes climbs a ladder.

CONCLUSION. This clinical case discloses the effectiveness of comprehensive rehabilitation of a patient with post-traumatic myelopathy (combat trauma) with the inclusion of Lake Taraskul in the rehabilitation program for hydrokinesiotherapy and peloidotherapy with sapropels.